PHARMACEUTICAL COMPOSITION FOR IMMUNOMODULATING AND ADJUVANT TREATMENT

Abstract: Pharmaceutical composition for immunomodulating and adjuvant therapy containing a metabolic stressor, 2-deoxy-D-ribose and further active components, i.e. ribose, DL-alanine, nicotonic acid, L-ascorbic acid, thiamin and glutamic acid amide is intended for immunomodulating and adjuvant therapy and for prevention of weakening of the immunity system.

Description: Pharmaceutical composition for immunomodulating and adjuvant treatment Field of invention The invention concerns a pharmaceutical preparation for immunomodulating and adjuvant treatment and for pre¬ vention of weakening of the immunity system. Background of the invention Immunomodulating compositions used at present time for treatment of various immunodeficiencies, autoimmunolo- gical ahd malignant diseases may according to their compo¬ sition and origin be divided into several groups. An im¬ portant group of these compositions is formed e.g. by the thymus hormones produced by extraction of animal tissues and distributed under the designation Thymus V-fraction (Hoffmann LaRoche), Thymodulin and Leucotropina (Ellem), Ty unox (Cilag) or TFX (Polfa) . A further group of immuno¬ modulating compounds to which much attention is paid espe¬ cially in the field of basic medical research are cytokins, which which are the main compounds controlling the immuni¬ ty response at the cell level. The technology of gene engi¬ neering facilitates the preparation of recombinant proteins which are active components of immunomodulating compositi¬ ons, e.g. Roferon (interferon alpha2) , (Hoffmann LaRoche), or hematopoetic growth factor G-CSF (Hoffmann LaRoche), distributed under the designation Neupogen. The already classic therapy by the use of interleukin-2 was discussed at the congress IMMUNOTHERAPY OF INFECTIONS (Berlin, May 4 to 7, 1993) especially from the wievpoint of failing in a part of the patients. Dialyzates of leucocytes are also very popular immunomodulating agents. In the Czech Republic they are known as Transfer factor (Sevac). To the oldest and still most often used agents belong compounds on the basis of the .- adjuvant activity of selected antigens derived from the components of bacterial membranes, e.g. Stava (Sevac), Olimostimulin (Medical Faculty of the Palacky University, Olo ouc). East medicine, especially in China, pays on the basis of the old tradition very big attention to immunostimulation compounds of plant origin and to the mechanism of their activity on the level of present euro- pian research (Immunotherapy of Infections, Berlin, May 4 to 7, 1993) . A composition known from the Greek Patent Specifica¬ tion No. 72 440 (dr. T.H. Alivizatos), containing a mixtu¬ re of D-ribose, DL-alanine, nicotinic acid and ascorbic acid may also be-considered as a composition having a pro¬ nounced immunomodulationg activity as this composition is able to rebuild the metabolic equilibrium and to strenthen the immunity of the organism. According to the modern conception of immunomodula¬ ting therapy targeted actions into the immunity of the organism are performed and it is necessary to define the area of the action and the character of the action of any pharmaceutical preparation. Such a definition is in the case of most still used immunomodulating compounds very complicated and difficult. The reason of all these difficul¬ ties reside on one side in gaining some of the immunomodu¬ lating compounds from biological sources (and it is diffi¬ cult to define all their possible biological activities, therefore), on the other side all these compounds have a number of biological activities that make the localization of their action in the regulating spheres of the immunity system impossible. Therapy based on the application of in¬ dividual cytokines is according to present experience com- plicated by a number of risks which are the result of in¬ volving of autoregulation mechnisms of the recipient of cytokins and successively the efficiency of the immunity system becomes lowered. It is also known that the activa¬ tion of the immunity system by an exogenous cytokine is not of full value as further natural components are mis¬ sing. For this reason it would be very desirable to prepa¬ re an immunomodulation preparation which would activate the system on a "physiological level", that means under involving all natural regulating and controlling spheres. Description of the invention The object of the invention resides in a pharmaceuti¬ cal composition for immunomodulating and adjuvant therapy which contains a metabolic stressor. The invention broadens the knowledge according to the abovementioned Greek Patent Specification according to knew information concerning the regulation of the immunity response and possible affecting of this response by metabolic stressors. A metabolic stres¬ sor is a natural non-toxic compound, in this case a deoxy- derivative of D-monosaceharides which is able to influence the production of cytokines, that means of the real regula¬ tors of the immunity response on cell level. The object of the invention is a pharmaceutical compo¬ sition for immunomodulation and adjuvant therapy containing D-ribose 10 - 35 g 2-deoxy-D-ribose (the metabolic stressor) 10 - 35 g DL-alpha-alanine 2 - 12 g nicotinic acid 2 - 10 g L-ascorbic acid 7 - 20 g thiamin 0,2 - 2 g glutamic acid amide 0,01-15 g the components are dissolved in 1 000 of physiological sa¬ line . The presence of deoxy-derivatives of D-monosacchari- des enables a targeted action on the immunity system and the use of the pharmaceutical preparation for treatment of a broader scope of immunity defects and of diseases ba¬ sed on the immunity system, especially of autoimmunity di¬ seases and of tumorous ilnesses in comparison with the above- mentioned Greek Patent Specification. Examples of invention Example 1 Composition of a pharmaceutical preparation accor¬ ding to embodiment A: 10 g D-ribose 10 2-deoxy-D-ribose 2 g DL-alpha-alanine 2 g nicotinic acid 7 g ascorbic acid dissolved in 1 000 g of physiological saline. Example 2 Activity of the preparation of Example 1 on the production of specific antibodies Specific antibodies were determined by ELISA in the serum of C3H mice the seventh day after immunisation by ovalbumine. The preparation according to the embodiment A was given repeatedly, 5 times 0,2 ml i.p. The results are given in the following table: group antibodies x % of the control cotrols 672,8 ± 55,62 100 test group 1055,3 ± 387,6 156,8 x mean ± SD From the values given in the Table it is clear that the pharmaceutical preparation according to this embodiment significantly promotes producing of specific antibodies. Example 3 Activity of the preparation according to the embodiment A (Example 1) on the proliferation of splenocytes induced by mitogens and on mixed lymphocyte reaction The test was performed by using the method of pending droplets. The preparation according to the embodiment A was given in an amount 3 x 0,2 ml i.p. to C3H-mice. One day following the last application the spleens were removed and the tests were performed. As mitogens Concavallin A (CON A), Phytohaemagglutinine (PHA), and lipopolysaccharides (LPS)were used. In the test on mixed lymphocyte cultures (MLR) splenocytes from DBA/1-mice were used as alloantigens The results of this tests are given in the following Table. From the results it is quite clear that the prepara¬ tion of the invention according to this embodiment does not stimulate the proliferation of lymphocytes induced by CON A, PHA and LPS, it is even possible to notice an inhibition of this proliferation. Group dp ± SE ■ % o f cont ro l s CON A controls 834,8 ± 175,0 100 test group 490,7 ± 70,9 58,8 PHA controls 1065,4 ± 306,0 100 test group 593,7 ± 125,9 55,7 LPS controls 1068,9 ± 274,4 100 test group 521,8 ± 96,7 44,8 MLR controls 494,2 ± 49,6 100 test group 477,3 ± 97,2 96,6 Example 4 Quantitative composition of the pharmaceutical preparation according to the invention, embodiment B 35 g D-ribose 35 g 2-deoxy-D-ribose 12 g DL-alpha-alanine 10 g nicotinic acid 20 g L-ascorbic acid dissolved in 1 000 ml of physiological saline. Example 5 Activity of the pharmaceutical preparation according to embodiment B on the production of specific antibodies Specific antibodies were determined by ELISA in the serum of C3H mice the seventh day after immunisation with ovalbumine. The preparation according to the embodiment B was given repeatedly, 5 times 0,2 ml i.p. The results are given in the following table. Group antibodies % of controls controls 672,8 ± 55,62 100 test group 592,4 ± 95,4 88 xmean ± SD From the results it is clear that the pharmaceutical preparation according to embodiment B does not stimulate the production of specific antibodies. Example 6 Activity of the preparation according to the embodiment B on the proliferation of splenocytes induced by mitogens and on mixed lymphocyte reaction The test was performed using the method of pending droplets. The preparation according to the embodiment B was applied in an amount of 3 x 0,2 ml i.p. to C3H-mice. One day after the last application the spleens were removed and the tests were performed. As mitogens Concavallin A (CON A), Phytohaemagglutinine (PHA), and lipopolysacchari¬ des (LPS) were used. In the test on mixed lymphocyte cultu¬ res (MLR) splenocytes from DBA/1-mice were used as alloan- tigens. Group dpm ± SE % of controls CON A controls 834,8 ± 175,0 100 test group 1109,4 ± 225,3 132,9 PHA controls 1065,4 ± 306,0 100 test group 1475,6 ± 213,4 138,5 LPS controls 1068,9 ± 274,4 100 test group 1500,6 ± 258,2 140,4 ' MLR controls 494,2 ± 49,6 100 test group 411,0 ± 47,7 83,2 • From the results it is clear that pharmaceutical pre¬ paration according to the embodiment B insignificantly sti¬ mulates the proliferation of lymphocytes induced by CON A, PHA and LPS. Remark: In the test no usual standars was used as the World Health Organization has not yet established a suitable and generally valid immunomodulating preparation with which other or new preparations should be compared (the problem of the definition of the characters of an immunomodulating preparation has already been discussed in paragraphs con¬ cerning the known state of art). Example 7 Activity of the pharamceutical preparation sccording to the embodiment B on the growth of the melanoma B16 in mice Mice melanoma B16 was implanted to 20 mice of the strain C57B16 intracutaneously at the right side. After in- healing of the transplantate the pharmaceutical preparation was applied after the conversion of the amount used to the body sufrace man/mouse according to Grossmann V. , Jarkov- ska I., Kvetina J.: Farmacie 9, 1988:400-404. That means that each mouse obtained always 0,04 ml of the preparation accoridng to the embodiment B into the tail vein. The pre¬ paration was applied during 28 days twenty times with an interval of two days after each fifth application. Control mice obtained the same amount of physiological saline (10 mice with transplantated melanoma B16). Each three days the tumors were observed and their size was estimated by the use of a slide calliper. At the same time the growth curve and the wight of the mice was estimated.During the course of the therapy by the use of the pharmaceutical pre¬ paration according to the embodiment B it was possible to prove a significant difference among the sizes of the tu¬ mours of the test groups and of controls. After the end of the therapy this difference was already not significant. It will apparently be necessary to find out the optimal sche¬ dule of application of the pharmaceutical preparation and to state the correlation among the activity of this prepa¬ ration and the amoung of the tumour mass before the begin¬ ning of the therapy. On the graphs 1, 2 and 3 the weight change of mice, relative volume and relative surface index of the tumour is given, respectively. Examp le 8 Activity of teh pharmaceutical preparation according to the embodiment B on the course of leukemia in rats In an orientation test the course of leukemia in rats of the strain SD/Ipcv was followed by estimating the weight, surviving of the rats and also haematological values. The haematological values for individual types of cells before the application of the preparation according to the embodi¬ ment B were as follows: erythrocytes 8 050 000 leucocytes 12 300 thrombocytes 826 000 differentially: blastic elements 4 myelocytes 0 metamyelocytes 6 rods 0 segments 25 eosinophiles 0 monocytes 4 lymphocytes 56 X-cells 9 The preparation was applied into the tail vein, the amount used was stated according to the ratio of body sur¬ face man/mouse (see Example 7). After the fifth dose the haematological values changed in a following manner: erythrocytes 7 350 000 leucocytes 10 900 thrombocytes 982 000 differentially: blastic elements: 4 myelocytes 0 metamyelocytes 3 rods 0 segments 46 eosinophiles 0 monocytes 3 lymphocytes 35 X-cells 9 Identical values were estimated every week. After the end of the therapy following values were obtained: erythrocytes 6 310 000 leucocytes 9 300 thrombocytes 1 162 000 differentially: blastic elements 0 myelocytes 0 metamyelocytes 0 rods 2 segments 39 eosinophiles 0 monocytes 6 lymphocytes 51 After the end of the therapy the animals were kept for 4 further weeks, at the end of that time following va¬ lues were obtained: erythrocytes 8 700 000 leucocytes 8 400 thrombocytes 778 000 differentially: blastic elements 0 myelocytes 0 metamyelocytes 0 rods 1 segments 22 eosinophiles 1 monocytes 4 lymphocytes 72 X-cells 0 During the whole test the weight of the animal was estimated. This value did not change significantly in the course of 8 weeks and the clinical state of the animal also did not significantly change. From the results it is clear that under the therapy bytheuse.of thepharmaceutical prepa¬ ration according to the embodiment B it was possible to " normalize" the haematologic picture of the treated animals, The results obtained in this example will serve as a starting material for targeted tests concerning the activi¬ ty of the pharmaceutical preparation on haematological tu¬ morous diseases and also on osteoporosis under conditions setted for pharmaceutical preparations for treatment of tumorous diseases. Example 9 Limit test for acute toxicity after a single i.v. and i.p. application of the preparation according to the embodiment B in mice and rats For performing the tests mice of the strain NMRI at the age of 6 weeks from a conventional breeding were used. The weight of males was 31 to 37 g, the weight of females was 27,5 to 32 g in the case of i.v. application, in the case of i.p. application the weight of males was 32 to 37 g and the weight of females was 28 to 33,5 g. The preparation according to the embodiment B was applied in a volume of 2 ml/lOOg in both modes of appli¬ cation. The i.v. application was performed into the tail vein, the i.p. application into the left lower quater of the peritoneal cavity. The animals were kept in an.air-con¬ ditioned room with a controlled regimen (12 hours light, 12 hours darkness, temperature of 23 to 25 C, relative humidity 50 to 70 %) in polypropylene cages (Type T3 Velaz) in groups of 5 animals in the case of females. Males were kept individually because of their agressivity in polypro¬ pylene cages (Type T2 Velaz) on a litter of sterilized wood shavings. The animals obtained a pelleted diet ST 1 (Velaz) and drinking water ad libitum during the whole du¬ ration of the test. The clinical state of health and the behaviour of the animals were followed every day during 21 days after the application of the preparation, the weight of the animals was estimated once a week. At the end of this time period all animals were subjected to acroscopical pathological investigation. The tests were performed according to the internatio¬ nally valuable OECD regulations for studies of acute toxi¬ city. Clinical investigations.. After the i.v. application deepened regular breezing was observed (immediately after the application till 30 minutes after the application) , then till the end of the time period for which the animals were followed it was not possible to observe any clinical symp¬ toms of toxicity. The growth curves also did not show any significat changes proving an optional toxic effect of the pharmaceutical preparation applied. After the i.p. applica¬ tion agin deepened breezing was obsarved, as weel as spas¬ tic walking together with traces of "write" spasms. After 30 minutes and through all following time period the animals did not develop any clinical symptomps of toxicity. During the abovementioned tests it was not possible to observe any dying of mice neither after i.v. application, nor after i.p. application. At the end of the time period of 21 days the animals were subjected to macroscopic pathological in¬ vestigation. After i.v. application no pathological devia¬ tion against the normal state could be proved neither in males, nor in females in the organs of peritoneal and chest cavity and also in the place of the application no patholo¬ gical changes could be observed. The observations in the case of the i.p. application were identical: on the surface of the spleen whitish coating could be observed, the spleen was partly or wholly attached to the stomach, the kidneys were a little lighter. According to the abovementioned results the limit test for acute toxicity under internationally valuable re¬ gulations of the OECD concerning the studies of acute toxi¬ city of a pharmaceutical preparation did not prove for a dose of 20 ml/kg after i.v. or i.p. application to mice of both sexes any symptoms of toxicity and it was also not possible to prove dying of the mice. For further tests rats of the strain Wistar in the age of 6 weeks were used (conventional breeding). The weight of males was 194 to 209 g and of females 159 to 170 g in the c ase of the i.v. application, in the case of the i.p. application the weight of males was 190 to 215 g and of females 161 to 175 g. The preparation according to the embodiment B was applied in an amount of 2 ml/ 100 g in both types of appli¬ cation. The i.v. application was performed into the tail vein, the i.p. application was performed into the left hig¬ her quarter of the peritoneal cavity. The animals were kept in an air-conditioned room with a controlled regimen (12 hours light, 12 hours darkness, temperature of 23 to 25 C, relative humidity 50 to 70 %) in polypropylene cages (Type T4 Velaz) in groups of 5 animals of identical sex on a lit¬ ter of sterilized wood shavings. The animals obtained a standard pelleted diet ST 1 (Velaz) and drinking water ad libitum during the whole duration of the test. The clinical state of health and the behaviour of the animals were followed every day during 21 days after the application of the preparation, the weight of the animals was estimated once a week. At the end of this time period all animals were subjected to macroscopical pathological investigation. The tests were performed according to the internatio¬ nally valuable OECD regulations for studies concerning the acute toxicity. Clinical investigations: after the i.p. and also af¬ ter the i.v. application deepened regular breezing was ob¬ served together with slight limpness which could be obser¬ ved till 5 hours after the application of the preparation. Throughout the remaining time period the animals did not show any clinical symptoms. The growth curves also did not show any significant changes proving an optional toxic ef- fects of the pharmaceutical preparation applied. During the test no animal died after the i.v. or after the i.p. appli¬ cation of the rpeparation. At the end of the period of 21 days for which the animals were followed the animals were subjected to macros- copical pathological investigation. After the i.v. applica¬ tion no pathological deviation against the normal state could be observed neither in males nor in females in the organs of peritoneal and chest cavity, also the place of the application remained without any pathological changes. Only the kidneys were a little lighter. After the i.p. ap¬ plication the observations for males and females were iden¬ tical: on the surface of the spleen whitish coating could be observed, the spleen was partly or wholly attached to the stomach, the liver lobes were attached together and had whitish coatings, the kidneys were slightly lighter. Histological investigations- were performed over the scope of investigations required by the OECD regulations. On the liver it was possible to observe local chronical productive hepatitis, the liver parenchyma was without pat¬ hological changes. The finding on the liver were under nor¬ mal limits, hyalinous deposits could be found in some epit¬ helial cells of the liver cortex. According to the abovementioned results the limit test for acute toxicity, performed under the OECD regula¬ tions for acute toxicity tests of a pharmaceutical composi¬ tion according to the embodiment B in an amount of 20 ml/kg i.v. or i.p. din not cause in rats of both sexes any signi¬ ficant toxical symptoms. No animal died during the test.

Claims: C l a i m s 1. Pharmaceutical composition for immunomodulating and adjuvant treatment, c a r a c t e r i z e d i n t h a t it contains D-ribose 10 to 35 g 2-deoxy-D-ribose (the metabolic stressor) 10 to 35 g DL-alpha-alanin 2 to 12 g nicotinic acid 2 to 10 g L-ascorbic acid 7 to 20 g thiamin 0,2 - 2 g glutamic acid amide 0,01 -15 g dissolved in 1 000 g of physiological saline. 2. Pharmaceutical composition according to claim 1, c h a r a c t e r i z e d i n t h a t it is in the form suitable for intravenous application. 3. Pharmaceutical composition according to claim 1, c h a r a c t e r i z e d i n t h a t it has a form suitable for intraperitoneal application. 4. The use of 2-deoxy-D-ribose for manufacturing a phar¬ maceutical composition according to claims 1 to 3 for immuno¬ modulating and adjuvant treatment.

Inventors: KUFUDAKI OLGA, KUFUDAKI, OLGA
Applicants: BLAZEK MARTIN, KUFUDAKI OLGA, BLAZEK, MARTIN, KUFUDAKI, OLGA
Application year: 1994
Main classification: A61K31
IPC codes: A61K9, A61K31, A61P37, C07H3